Provider Demographics
NPI:1578034088
Name:MISSION MEDSTAFF, LLC
Entity type:Organization
Organization Name:MISSION MEDSTAFF, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-271-2847
Mailing Address - Street 1:7300 STATE HIGHWAY 121 STE 250
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1991
Mailing Address - Country:US
Mailing Address - Phone:210-875-0853
Mailing Address - Fax:
Practice Address - Street 1:416A W MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2534
Practice Address - Country:US
Practice Address - Phone:336-268-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MISSION MEDSTAFF, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-09
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6602032Medicaid
NC3418800Medicaid